Double Vision

One cannot describe Mark Rothstein without a full appreciation for duality.

A lawyer who is a professor of medicine. A natural teacher whose focus is research. A "big-picture" visionary with a keen eye for statistical detail. A serious intellectual and academician who dotes on his beloved dogs.

These opposing traits fit comfortably with Rothstein, and countless policy-makers and colleagues in law and medicine benefit from his ability to analyze issues from different points of view.

As the Herbert F. Boehl Chair of Law and Medicine and director of the University of Louisville Institute for Bioethics, Health Policy and Law, Rothstein conducts research and advises state legislatures, the Centers for Disease Control and Prevention, the National Institutes of Health and other national groups on a variety of issues.

The institute, a collaborative program between UofL's School of Medicine and Brandeis School of Law, was established in 2001 to conduct interdisciplinary research, teaching and service in bioethics, health sciences, public health and law.

"Our specialty is interdisciplinary research," Rothstein explains. "Our program is unique because our faculty -- from a variety of professional and academic backgrounds -- can look at a problem like access to health care and conduct a bioethics analysis, policy analysis and a case law-legislative comparative analysis. We can look at issues from a variety of perspectives."

In fact, Rothstein's group currently is analyzing several health issues with national implications. For instance, the CDC has requested a study of the child fatality review laws in every state. According to Rothstein, this is no simple task.

"Every state has a law that all child fatalities be reported to a state agency. The ability to track any regional or national trends would be very valuable. However, the laws are so different state to state - in terms of agencies collecting the data and what data they collect - that at present no one can aggregate this information nationwide."

By coordinating expertise in law, epidemiology and public health from his own institute, Rothstein and his colleagues intend to produce a document that clearly shows what data collected at the state level are most valuable. In the end, Rothstein hopes the study will assist the CDC in advising state-level policy makers to adopt a more uniform data collection system. In the long run, the availability of this data may lead to improved safety legislation.

This is by no means the first time Rothstein has been asked to offer his expertise to national discussions on health policy. He routinely conducts several studies of national importance at any given time and currently sits on no fewer than five national committees, including those advising the Department of Energy, the National Institute of General Medical Sciences, and the CDC. He also is chair of the privacy and confidentiality subcommittee of the National Committee on Vital and Health Statistics -- a body to which he first was appointed by former Health and Human Services Secretary Donna Shalala.

Building a Reputation

While attending law school at Georgetown University Rothstein had a chance meeting with another law student in the student lounge.

"I had a strict policy against dating other law students," Rothstein remembers. "I only broke that policy once."

Rothstein later married that student, the former Laura Friesen, who now serves as dean of the University of Louisville Brandeis School of Law. Laura says that meeting Mark was the best part of her Georgetown experience.

"We've served on five different faculties together, and we're still married," she says.

At least part of their marital success has been their ability to support each other's work while allowing enough professional space and freedom. The Rothsteins recall writing one article together in the 1970s, and both agree they will never do it again.

According to Laura, "Mark is a perfectionist. When you co-write an article with him, you can count on the fact that he'll re-write it at least 10 times."

Mark began his career in health law as a lawyer with the Occupational Safety and Health Review Commission by analyzing workplace health issues. Soon after leaving government service for academia, he was a recognized expert in occupational safety and health law, having published his first book on the subject in 1978 -- "at the ripe old age of 29," Mark says.

Beginning in 1980, two opportunities ultimately set the course of Mark's career. He was teaching at the West Virginia University College of Law and had developed a friendship with the director of university's occupational medicine clinic. The clinic's caseload was made up of the most difficult work-related injury cases in the state.

According to Mark, "These people had complicated legal problems to deal with on top of their physical problems.

"We started having medical students and law students work together to help these patients with all of the issues related to their injuries -- including workers compensation, unemployment, insurance and discrimination."

As the number of cases grew and the coordination of the program took more time, Rothstein was asked to join the medical school faculty.

Also in 1980, the U.S. Congress became concerned about the very first cases of genetic testing in the workplace.

The congressional Office of Technology Assessment needed someone to study the legal and ethical issues of this brand-new field. They sought help from Mark Rothstein.

"They asked me to write a report on this issue. I said, 'I don't know anything about genetic testing,' and they said, 'No one does!'" Mark recalls.

After conducting an in-depth analysis of the issues and testifying before Congress (for the first of what would become many legislative appearances), he realized that the science of genetics was moving quickly, and the law would have to keep up.

The ethical and legal issues of genetics have remained his focus ever since.

"I had no idea where the field would be today," he explains. 

However, as the Human Genome Project comes to a close, Rothstein has solidified his position as a leading expert in the field.

Impressive Company

Recently, Mark's team was selected by the NIH as one of a group of nine to conduct a major study of pharmacogenomics.

Scientific grants were awarded to the University of Chicago, Georgetown, Harvard, the Mayo Clinic, UCLA and the University of California at San Francisco. Yale and Stanford were chosen to work on related informatics issues while the Institute for Bioethics, Health Policy and Law at the University of Louisville studied the bioethics issues, including privacy, confidentiality and informed consent.

"When you're chosen to work with these institutions," Mark says, "it makes a statement about the quality of your work and your ability to support the other schools."

Mark came to Louisville from the University of Houston Law Center, where he was director of the Health Law and Policy Institute. Under his leadership since 1986, the Houston program was widely recognized as the benchmark center for academic health law.

In 1991, Texas lawmakers increased the program's scope and visibility by assigning the institute responsibility for providing ongoing health policy research for the Texas legislature. The accompanying appropriations made it possible to add full-time research faculty and become more involved in state and national policy-making.

While Mark was directing the country's top-rated health law program, Laura was serving as associate dean for student affairs at the University of Houston. In the spring of 2001, she found herself as a leading candidate to become dean of the Brandeis School of Law at UofL.

"I did want the job," she says, "but in our careers we have never made a move where one of us was unhappy."

UofL recruited Mark and his team as well. Taking advantage of Kentucky's unique Research Challenge Trust Fund (commonly known as "Bucks for Brains"), the university was able to offer Mark an endowed professorship, support for additional faculty and the opportunity to build a true interdisciplinary program from the ground up. It was an opportunity that both Rothsteins had to explore.

Mark established the UofL Institute for Bioethics, Health Policy and Law with four faculty members who came to Louisville from Houston and additional faculty he recruited from other institutions.

"The decision to move to Louisville from Houston was an easy one," explains Mary Anderlik, J.D., Ph.D. Anderlik, an associate professor at the institute, says she joined the team at UofL because "Mark has this amazing ability to identify the next big issue -- developments just on or over the horizon that need thoughtful consideration now."

According to Cathy Rupf, assistant director of the program, who also moved from Houston, "The Institute started with a cell phone, a few grants and Mark's drive and determination to put the program on the map. Building a program from the ground up is one of the most exciting and fulfilling opportunities one can be afforded."

"I've been very pleased with the transition," Mark says from his office in the Louisville Medical Center's MedCenter One. "The medical school faculty has embraced me and the institute. We're doing some very interesting collaborative work."

The institute's tie to the law school has been beneficial as well. While Mark's offices and staff are located on the Health Sciences Campus in downtown Louisville, he also teaches at the School of Law on UofL's Belknap campus.

"The institute gives our students the opportunity to do research in new areas," Laura says. "The cross fertilization is helpful."

The institute has already caught the attention of key constituents in Kentucky. Mark and his group have offered expertise and opinions to the Council on Postsecondary Education, the Office for the New Economy and the state legislature.

"We'd like to explore working with the Kentucky legislature as we did the Texas legislature," Mark says. "We are quickly building a statewide presence."

While working to build that presence, Mark has continued his research, including completing three new works for publication in 2002.

He also has maintained his busy lecture schedule. This spring, among his more than a dozen speeches, Mark delivered a major pharmacogenomics address at the NIH, served as the Merck Distinguished Scholar in Residence at Seton Hall University and gave an address at the Biotechnology Industry Organization's 2002 annual conference in Toronto.

Between their teaching, publishing, research and lecture schedules, the Rothsteins spend relatively little time at home together. With their two daughters each away at school (Lisa graduated from the University of Missouri -- Columbia in May, the same weekend that Julia graduated from the Georgetown University Law Center), "the main problem we have in planning our travel schedules is our dogs," Laura says.

"Mark had to convince me to get dogs - and getting me a baby grand piano first helped."

Of course, the two bichons quickly won both Rothsteins over and now are a cherished part of the family. The couple enjoys going on an annual summer cruise to at least temporarily escape their busy lives. "And we both like sports -- basketball in particular," Laura notes. Mark would add horse racing to the list.

"We know we should try to relax more, but we really enjoy our work," he says.

Yet another snapshot of duality for Mark Rothstein: He's a "regular guy" who enjoys relaxing diversions but doesn't fully embrace them because he loves his work so much.